Hypertension Affects Children and Adolescents

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Measuring and Diagnosing High Blood Pressure in Children

Yearly visits to a physician which include the checking of your child's blood pressure is the only way to diagnose hypertension. Physicians should begin checking your child's blood pressure yearly after the age of three. The response to any abnormalities that are detected should be to take more readings to appropriately diagnose hypertension. High blood pressure is defined differently for children than it is for adults. For kids, blood pressure greater than the 95th percentile for their age, height, and gender is defined as high blood pressure. Physicians use a chart to determine which percentile a child's blood pressure is located[1](Chart examples). It is important to properly diagnose your child's hypertension early on, because children who have high blood pressure are likely to have high blood pressure later in life.
Quick Snapshot

Blood pressure is the amount of force on your arteries and your heart rate is number of times per minute your heart beats. Anyone can have hypertension, it is not just a disease for the elderly. Early diagnosis and treatment can help prevent the risk of the negative side effects of this disease.

Blood Pressure is measured as systolic and diastolic pressures. These refer to the blood pressure when the heart beats and while the heart is at rest between beats. The unit of measurement is millimeters of mercury or mmHg. Normal blood pressure range for adults is less than 120 systolic and less than 80 diastolic or 120/80. High blood pressure is considered a systolic pressure at 140 or higher or a diastolic pressure of 90 or higher (140/90). However, a different form of classification is used for children.

Normal BP: Systolic and Diastolic <90th percentile
Prehypertension: Systolic or Diastolic > 90th percentile to <95th percentile or BP >120/80mmHg to <95th percentile
Stage 1 Hypertension: Systolic and/or diastolic > 95th percentile to <99th percentile
Stage 2 Hypertension: Systolic and/or Diastolic >99th percentile

Find out more about the impact of these numbers on your child's health.
(High Blood Pressure in Children 2)

Frequency of Hypertension(3)

The true incidence of hypertension in the pediatric population is not known, partially due to vagueness of the definition of hypertension and the lack of extensive studies done that allowed for correlation of BP with adverse events in children. However, reports from small populations have been collected.

Types of Hypertension [7]

There are several different types of hypertension. The most frequent cases are either primary (essential) hypertension or secondary hypertension.Understanding the cause of your hypertension will help you have a better understanding of certain factors affecting your blood pressure.

Primary (essential) hypertension
For most adults, there is no identifiable cause of high blood pressure. This type of high blood pressure is called primary hypertension. This type tends to develop gradually over many years.

Secondary hypertension
Some individuals have high blood pressure as a result of a different underlying condition or disease. This type of high blood pressure is called secondary hypertension. It appears to develop more suddenly and can also be caused by various conditions and medications.

Risk Factors

Children (0-14 years) [1]

Premature birth may lead to high blood pressure in infants
Family history
Stress
Excess weight
Unhealthy diet
Insufficient exercise

Adolescents (15-17 years)

Major Contributing factors: Kidney disorders[1]
- Family history [2]
- Race (African Americans are at increased risk) [2]
- Obesity or excess weight[2]
Heart disease[2]
Medicine: use of steroids or oral contraceptives [8]
Having high cholesterol and triglycerides[7]

Symptoms(5)

Headache
Difficulty falling asleep
Daytime Tiredness
Chest Pain
Nausea
Frequent dizziness
Shortness of breath
Abdominal Pain
Difficulty concentrating/Poor School Performance

If you believe your children is experiencing any of the above symptoms because of high blood pressure, it may be time to see you doctor. Check out the following link with more information on when a doctor's visit is necessary:
When to See Your Doctor.

Treatments(2)

High blood pressure is treated similarly in children and adults.

Weight management: talk to your physician for healthy weight management/loss
Incorporate a heart healthy diet
Physical activity (60 minutes/day)
Medicine prescribed by physician
A healthy diet and regular exercise will help reduce the risk of developing other chronic diseases such as obesity, type 2 diabetes, and cardiovascular disease

Common Medications

The following are medications used to treat hypertension. Click on the medication to learn more about how it works to lower blood pressure.

Prevention

It's important to detect hypertension early. It is now recommended that children have their blood pressure checked beginning at age three, and even sooner for those that are at high risk. Many types of medications are available, but first a pediatrician may prescribe a change in lifestyle. Children and their parents should follow these steps toward prevention: